N.Y. Comp. Codes R. & Regs. tit. 14 § 818.2

Current through Register Vol. 46, No. 25, June 18, 2024

Section 818.2 - General service standards

(a)Policies and procedures. The program governing authority must approve written policies, procedures and methods governing the provision of strength based, person centered, trauma informed services to patients in compliance with Office regulations including a description of each service provided and a description of evidence-based practices employed in all aspects of service delivery including but not limited to group, individual and family treatment. Such policies and procedures shall address, at a minimum, the following:

(1) procedures and specific criteria for admission, retention, transfer, referrals and discharge;

(2) level of care determinations utilizing the OASAS level of care determination protocol, treatment/recovery plans, and placement services;

(3) staffing, including but not limited to, training, supervision, and use of student interns, peers, and volunteers;

(4) the provision of medical and psychiatric services, including screening and referral for associated physical or mental health conditions;

(5) a schedule of fees for services rendered;

(6) infection control procedures;

(7) cooperative agreements with other substance use disorder service providers and other providers of services that the patient may need;

(8) compliance with other requirements of applicable local, state and federal laws and regulations, OASAS guidance documents and standards of care regarding, but not limited to:

(i) education, counseling, prevention and treatment of transmissible infections, including viral hepatitis, sexually transmitted infections and HIV; regarding HIV, such education, counseling, prevention and treatment shall include condom use, testing, pre- and post-exposure prophylaxis and treatment;

(ii) the use of toxicology tests as clinically appropriate; and

(iii) medication and the use of medication for addiction treatment;

(iv) if acupuncture is provided it must be provided in accordance with Part 830 of this Title;

(v) the use of a problem gambling screen approved by OASAS.

(9) record keeping procedures which ensure that documentation is accurate, timely, prepared by appropriate staff, and in conformance with the federal confidentiality regulations contained in 42 Code of Federal Regulations Part 2; and

(10) Utilization review and quality improvement. All programs must have a utilization review process, a quality improvement process, and a written plan that identifies key performance measures.

(b)Program goals. An inpatient program shall have as its goals:

(1) the improvement of functioning and development of coping skills necessary to enable the patient to be safely, adequately and responsibly treated in the least intensive environment; and

(2) the development of individualized plans to support the maintenance of recovery, attain selfsufficiency, and improve the patient's quality of life.

(c)Minimum services. Inpatient programs shall provide, at a minimum, the following strength based, person centered, trauma informed services as clinically indicated and specified in the individualized treatment/recovery plan:

(1) trauma-informed individual and group counseling and activities therapy. Group counseling sessions must be structured in size and duration to maximize therapeutic benefit for each participant. Program policies must include a process for determining group size, group purpose, monitoring patient experience, and assessing group efficacy;

(2) skills to identify and manage craving and urges to use, anticipate recurrent substance use, and develop a safety plan;

(3) education about, orientation to, and the opportunity for participation in, available and relevant self-help groups and other forms of peer support;

(4) assessment and referral services for patients and significant others;

(5) HIV education, risk assessment, supportive counseling and referral:

(i) offer viral hepatitis testing; testing may be done on site or by referral;

(ii) offer HIV testing; testing may not be conducted without patient written informed consent except in situations specifically authorized by law; testing may be done on site or by referral; individuals on a regimen of pre- or post-exposure prophylaxis, must be permitted to continue the regimen until consultation with the prescribing professional occurs;

(6) vocational and/or educational assessment; and

(7) medical and psychiatric consultation.

(d)Medication for Addiction Treatment.

(1) All programs shall maintain a patient with substance use disorder on approved medication, including those federal Food and Drug Administration (FDA) approved medications to treat substance use disorder, if deemed clinically appropriate and in collaboration with the patient's existing provider, and with patient consent, in accordance with federal and state rules and guidance issued by the Office. The program shall document such contact with the existing program or practitioner prescribing such medications.

(2) To facilitate access to full opioid agonist medication for patients who are maintained on such medication at the time of admission or who choose to start such medication during admission, the program shall develop a formal agreement with at least one Opioid Treatment Program (OTP) certified by the Office to facilitate patient access to full opioid agonist medication, if clinically appropriate. Such agreements shall address the program and the OTPs responsibilities to facilitate patient access to such medication in accordance with guidance issued by the Office.

(3) The program shall provide FDA approved medications to treat substance use disorder to an existing patient or prospective patient seeking admission to an Office certified program in accordance with all federal and state rules and guidance issued by the Office.

(4) The program shall provide education to an existing patient or prospective patient with substance use disorder about approved medications for the treatment of substance use disorder if the patient is not already taking such medications, including the benefits and risks. The program shall document such discussion and the outcome of such discussion, including a patient's preference for or refusal of medication, in the patients record.

(5) The program shall ensure that the patient's discharge plan includes an appointment with a treatment provider or program that can continue the medication post-discharge.

(e)Emergency medical kit. Pursuant to Part 800 of this Title, all programs must maintain an emergency medical kit at each certified or funded location; such kit must include basic first aid and naloxone emergency overdose prevention kits sufficient to meet the needs of the program. Programs must develop and implement a plan to have staff trained in the prescribed use of a naloxone overdose prevention kit such that it is available for use during all program hours of operation.

(1) All staff and patients should be notified of the existence of the naloxone overdose prevention kit and the authorized administering staff.

(2) Nothing in this regulation shall preclude patients from becoming authorized in the administration of the naloxone emergency overdose prevention kit, provided however, the program director must be notified of the availability of any additional authorized users.

(f)Food and nutrition.

(1) Each facility shall provide to each patient three (3) nutritious meals each day which furnish sufficient nutrients and calories to meet normal needs as well as the special needs of persons in recovery.

(2) The facility shall have available snacks and beverages between meals.

(3) A dietician or dietetic technician acting within their scope of practice shall provide menu planning services. Other suitable staff shall be responsible for the procurement of food supplies and the training and directing of food preparation and serving personnel.

(g)Certified capacity. The certified bed capacity of each inpatient program shall not be exceeded at any time except with the written approval of the Office.

(h)Educational and child care services. Each inpatient program which provides services to school-age youth must make arrangements to ensure the availability of required basic educational and child care services. (i) Medicaid. Providers seeking Medicaid reimbursement must comply with the requirements of this Part and Part 841 of this Title.

(j)Medical emergencies. Each inpatient program shall have written agreements with general hospitals for the immediate transfer of patients or prospective patients in need of acute hospital care, unless the inpatient program is co-located in a general hospital.

(k)Telehealth. Services may be delivered using telehealth consistent with Part 830 of this Title.

N.Y. Comp. Codes R. & Regs. Tit. 14 § 818.2

Amended New York State Register September 14, 2022/Volume XLIV, Issue 37, eff. 10/1/2022